If you have a balance remaining in your HealthFund, present your Aetna ID card to your provider each time you receive services. The card clearly designates that you’re enrolled in an Aetna plan. It also gives your provider a website and phone number for contacting Aetna to verify your HealthFund balance. Your provider bills Aetna for the services you receive, and, if there’s money in your HealthFund, Aetna pays your provider directly from your HealthFund balance. Pharmacy claims also can be paid from your HealthFund account; however, you must file a paper claim form to receive reimbursement. Claim forms are available here.
If you enroll in a health care flexible spending account (FSA), funds in your HealthFund must be used first before you can access your FSA funds.
When you go to an in-network participating doctor:
Present your Aetna ID card.
Your provider should recognize that "AHF" is Aetna HealthFund and should file your claim directly with Aetna for reimbursement.
The card provides a website and phone number to verify your HealthFund balance. If there’s money in your HealthFund, that provider bills Aetna and Aetna pays your provider directly from your HealthFund balance.
If you receive emergency care from an out-of-network provider, you may need to pay the bill and file a claim for reimbursement. Filing your medical claim accesses your HealthFund dollars, too.
All expenses eligible for coverage under the Medical plan are payable from your HealthFund. But remember that you also have the Aldine ISD-provided preventive care benefit that pays preventive care expenses, such as costs for annual wellness exams, at 100%.
If the provider enters a request for the entire expense and it’s more than you have in your HealthFund, Aetna pays the amount available, and the provider bills you for the rest. The provider also has the right to request any amounts not available in the HealthFund at the point-of-service or otherwise payable by the plan.
You can check your HealthFund balance at Aetna Navigator. You need to register before accessing the system. You can also get your balance by calling Aetna member services.
Pay your copay at the pharmacy and file a paper claim for reimbursement with Aetna using your pharmacy receipt. Aetna mails you a check if you have funds available. Claim forms are available here.
As a participant in a Consumer option, you can maximize your savings by using a health care FSA to pay expenses that aren’t covered in a Consumer option, such as coinsurance amounts. If you enroll in a health care FSA, you must deplete the funds in your HealthFund before you can access your FSA.
For any benefits question or concern, including 24/7 Nurse Line access, one call does it all.
Call us at 866-284-AISD (2473)